INTRODUCTION: There is a lack of guidelines or formal systematic synthesis of evidence for nutrition therapy in older critically ill patients. This study is a scoping review to explore the state of evidence in this population. METHOD: MEDLINE and Embase were searched from inception until 9 February 2022 for studies that enrolled critically ill patients aged ≥60 years and investigated any area of nutrition therapy. No language or study design restrictions were applied. RESULTS: Thirty-two studies (5 randomised controlled trials) with 6 topics were identified: (1) nutrition screening and assessments, (2) muscle mass assessment, (3) route or timing of nutrition therapy, (4) determination of energy and protein requirements, (5) energy and protein intake, and (6) pharmaconutrition. Topics (1), (3) and (6) had similar findings among general adult intensive care unit (ICU) patients. Skeletal muscle mass at ICU admission was significantly lower in older versus young patients. Among older ICU patients, low muscularity at ICU admission increased the risk of adverse outcomes. Predicted energy requirements using weight-based equations significantly deviated from indirect calorimetry measurements in older vs younger patients. Older ICU patients required higher protein intake (>1.5g/kg/day) than younger patients to achieve nitrogen balance. However, at similar protein intake, older patients had a higher risk of azotaemia. CONCLUSION Based on limited evidence, assessment of muscle mass, indirect calorimetry and careful monitoring of urea level may be important to guide nutrition therapy in older ICU patients. Other nutrition recommendations for general ICU patients may be used for older patients with sound clinical discretion.
Adult ; Humans ; Aged ; Critical Illness/therapy* ; Enteral Nutrition ; Nutritional Support ; Nutritional Requirements ; Intensive Care Units ; Energy Intake

Objective: To explore the knowledge, attitude and behavior of salt reduction in adults of Beijing in 2017. Methods: Based on the monitoring data of chronic diseases and corresponding risk factors in adults of Beijing in 2017, the indicators of salt reduction knowledge, attitude and behavior of 13 240 participants aged 18-79 years old were analyzed. The awareness rate, attitude support rate and behavior rate were calculated by complex weighting method, and compared among different age groups, genders, residential areas, and history of hypertension. The proportion of people taking various salt reduction measures to the total number of people was compared. Results: The awareness rate of recommended daily salt intake, the awareness of hypertension caused or aggravated by more salt intake, the attitude support rate and behavior rate of adults were 31.77%, 88.56%, 90.27% and 53.86%, respectively. After weighted adjustment, the awareness rate of recommended daily salt intake was 31.08%, which increased with age (χ²_trend=431.56, P<0.001) and education level (χ²_trend=95.44, P<0.001). The awareness rate of women was higher than that of men (χ²=118.89, P<0.001), and the awareness rate of population in urban areas was higher than that of population in suburban areas (χ²=34.09, P=0.001). The awareness rate of hypertension caused or aggravated by eating more salt was 86.73%. The support rate of salt reduction attitude was 90.45%. The rate of salt-reducing behavior was 54.05%. Among different salt reduction measures, reducing salt when cooking was the most common measure (52.41%), while the least common one (35.22%) was using low sodium salt. Logistic regression model analysis showed that the gender, age, education level, self-reported history of hypertension, awareness of salt recommendation, awareness of hypertension caused or aggravated by eating more salt, and salt reduction attitude were significantly associated with salt reduction behavior. Conclusion: In 2017, adults in Beijing have a basic understanding of the impact of high-salt diet on health and support salt reduction, but the rate of salt reduction behavior is still relatively low. There are obvious gender and age differences, and the salt reduction measure is simple. Targeted measures should be taken to promote the formation of salt reduction behavior.
Adolescent ; Adult ; Aged ; Beijing ; Diet, Sodium-Restricted ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hypertension/prevention & control* ; Male ; Middle Aged ; Recommended Dietary Allowances ; Sodium Chloride, Dietary ; Young Adult

Recommended Daily Allowance (RDA) and upper tolerable intake level (UL) for each component.RESULTS: Ninety percent of supplements claimed to “boost T”, 50% “improve libido”, and 48% “feel stronger”. One-hundred nine unique components were found, with a mean number of 8.3 per product. On PubMed, 24.8% of supplements had data showing an increase in T with supplementation, 10.1% had data showing a decrease in T, and 18.3% had data showing no change in T. No data were found on 61.5% of supplements on their effect on T. Supplements contained a median 1,291% of the RDA for vitamin B12, 807.6% for vitamin B6, 272% of zinc, 200% of vitamin B5, and 187.5% of vitamin B3. Thirteen products exceeded the US Food and Drug Administration UL of ingredients (zinc, vitamin B3, and magnesium).CONCLUSIONS: Ninety percent of “T booster” supplements claimed to boost T. However, only 24.8% of these had data to support these claims. A total of 10.1% contained components with data suggesting a negative effect on T. Many had supra-therapeutic doses of vitamins and minerals, occasionally over the UL. Patients should be informed that “T booster” supplements may not have ingredients to support their claims.]]>
Humans ; Male ; Minerals ; Miners ; Niacinamide ; Pantothenic Acid ; Recommended Dietary Allowances ; Testosterone ; United States Food and Drug Administration ; Vitamin B 12 ; Vitamin B 6 ; Vitamins ; Zinc

PURPOSE: This study evaluated the dietary quality of lunches consumed through home meals, institutional meals, and eating-out at restaurants in Chinese adults.METHODS: The total of 3,708 people (aged 20 ~ 64) were selected from the data of the 2011 China Health and Nutrition Survey and divided into three groups: the home (HM, 2,845 people), institutional (IM, 579 people), and eating-out (EO, 284 people) meal groups. Dietary intakes of eight food groups, the frequency of eating certain foods, food group intake pattern, dietary diversity and the variety score of lunches were analyzed.RESULTS: The meat intake of IM and EO were higher than that of HM (p < 0.05), and the vegetable intake was the highest in HM, followed by IM and EO (p < 0.05). The intake of fruit and milk · dairy products were extremely low in all the groups. Compared with 1/3 daily recommended intake, the meat intake was above the standard in all the groups and the vegetable intake was insufficient only in EO. The most frequently consumed food in all the groups was rice, followed by pork. The relatively desirable food group pattern, “grain + meat + vegetable”, was highest in IM (66.0%) and lowest in EO (48.2%). The “grain + vegetable” pattern in HM and the “grain + meat” pattern in EO were relatively higher than that in the other groups. The dietary diversity score (p < 0.001) and dietary variety score (p < 0.001) were significantly higher in IM than that in the HM or EO.CONCLUSION: The lunches of Chinese adults had common problems in excess meat intake and a severe lack of fruit and milk · dairy products. Even institutional meals were not ideal as single meals for Chinese adults, although they were better in food diversity. Customized dietary educational programs based on balanced meal plans need to be established, especially for those Chinese people having lunch at home or eating out. In addition, a systematic food service program should be developed and firmly implemented.
Adult ; Asian Continental Ancestry Group ; China ; Dairy Products ; Eating ; Food Services ; Fruit ; Humans ; Lunch ; Meals ; Meat ; Milk ; Nutrition Surveys ; Recommended Dietary Allowances ; Red Meat ; Restaurants ; Vegetables

BACKGROUND: Sarcopenia has become a major concern owing to its association with a high risk of fall or fracture and metabolic impairments. There is insufficient evidence to support the role of dietary protein intake in reducing the prevalence of sarcopenia. This study was conducted to investigate the variation in low skeletal muscle index (SMI) with the dietary levels of protein intake.METHODS: This study analyzed data of 3,482 male and 4,838 female aged 50 years or older from the Korean National Health and Nutrition Examination Survey (KNHNES) database (2008–2011). Low SMI was indicated by a value <0.789 in male and <0.512 in female. Multiple logistic regression was performed to analyze the association of SMI with protein intake, whereby it was tested whether the dietary intake of proteins met the estimated average requirement (EAR) or the reference nutrient intake (RNI) as stated in the dietary reference intake (DRI) for Koreans, 2015.RESULTS: Irrespective of sex, the prevalence of low SMI was significantly high when the protein intake did not meet the EAR or RNI. Following adjustment for covariates, the odds ratio (OR) for low SMI in subjects with unmet EARs was 1.63 (1.28–2.09) in male and 1.35 (1.10–1.66) in female. The OR for low SMI in subjects with unmet RNI was 1.74 (1.38–2.18) in male and 1.39 (1.14–1.69) in female.CONCLUSION: The prevalence of low SMI was significantly higher when the protein intake did not meet the EAR or RNI as stated in the DRI for Koreans.
Dietary Proteins ; Ear ; Female ; Humans ; Logistic Models ; Male ; Muscle, Skeletal ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Protein Deficiency ; Recommended Dietary Allowances ; Sarcopenia

BACKGROUND/OBJECTIVES: The objectives of this study were to evaluate the accuracy of the Dietary Reference Intakes (DRI) for estimating the energy requirements of older adults, and to develop and validate new equations for predicting the energy requirements of this population group. MATERIALS/METHODS: The study subjects were 25 men and 23 women with a mean age of 72.2 ± 3.9 years and 70.0 ± 3.3 years, and mean BMI of 24.0 ± 2.1 and 23.9 ± 2.7, respectively. The total energy expenditure (TEE) was measured by using the doubly labeled water (DLW) method, and used to validate the DRI predictive equations for estimated energy requirements (EER) and to develop new EER predictive equations. These developed equations were cross-validated by using the leave-one-out technique. RESULTS: In men, the DRI equation had a −7.2% bias and accurately predicted the EER (meaning EER values within ±10% of the measured TEE) for 64% of the subjects, whereas our developed equation had a bias of −0.1% and an accuracy rate of 84%. In women, the bias was −6.6% for the DRI equation and 0.2% for our developed equation, and the accuracy rate was 74% and 83%, respectively. The predicted EER was strongly correlated with the measured TEE, for both the DRI equations and our developed equations (Pearson's r = 0.915 and 0.908, respectively). CONCLUSIONS: The DRI equations provided an acceptable prediction of EER in older adults and these study results therefore support the use of these equations in this population group. Our developed equations had a better predictive accuracy than the DRI equations, but more studies need to be performed to assess the performance of these new equations when applied to an independent sample of older adults.
Adult ; Aged ; Bias (Epidemiology) ; Energy Metabolism ; Female ; Humans ; Male ; Methods ; Nutritional Requirements ; Population Groups ; Recommended Dietary Allowances ; Water

PURPOSE: This study verified the reliability and validity of the Diet Quality Index for Indian children (DQIIC). METHODS: The study sample included 100 school going boys and girls (7–9 years). The dietary behavior of children was studied using a questionnaire and 24-hour dietary recall. The DQIIC comprises 21 items which aimed to assess the diet of Indian children on the basis of variety, adequacy of consumption of dietary components, and moderation in the amount of nutrients that are associated with diseases and dietary habits. The reliability of the DQIIC was assessed using the split half method, Cronbach's alpha, and test retest reliability. Content validity was evaluated using content validity ratio (CVR). RESULTS: The intake of iron was found to be less than the recommended dietary allowances. There was frequent consumption of empty calorie packaged foods and higher than the recommended amount of sodium. Reliability of the DQIIC was 0.85 by split half method and the correlation coefficient for test retest reliability was 0.87. Cronbach's alpha was 0.62 and CVR was 0.85 for this index. Most of the children fell in the moderately healthy category. CONCLUSION: The DQIIC is a reliable and valid tool to assess the diet quality of Indian children between 7–9 years.
Child ; Diet ; Female ; Food Habits ; Humans ; Iron ; Methods ; Nutritional Status ; Recommended Dietary Allowances ; Reproducibility of Results ; Sodium

We investigated weight loss effect of personalized diet education in overweight/obese Korean adults. Overweight/obese Korean adults (body mass index [BMI] ≥ 23 kg/m2 or waist circumference [WC] ≥ 90 cm for men, ≥ 85 cm for women) were recruited, and 40 participants who completed the 10-week intervention were finally included in the analyses. At first visit, study participants (small group with individual counseling) were educated for optimal diet by clinical dietitian, and checked for their compliance through telephone/text message every 1–2 week during the intervention. Anthropometric and biochemical parameters and dietary intake were investigated. Body weight, BMI, WC, and body fat mass were significantly reduced in whole participants. Hemoglobin A1c, insulin, and low-density lipoprotein cholesterol were also significantly decreased after the intervention. Total energy intake (EI) during the intervention was not significantly decreased compared to the baseline value, but the proportions of energy derived from macronutrients were within the ranges recommended by 2015 Dietary Reference Intake for Koreans. Based on actual EI, participants were classified into high-adherence (HA) (prescribed EI ± 25%, n = 29), low-adherence I (LA-I) (< 75% of prescribed EI, n = 7), and low-adherence II (LA-II) group (> 125% of prescribed EI, n = 4). Only HA group showed significant improvements in anthropometric parameters, glycemic control and lipid profile. Interestingly, LA-I group showed significant increases in glucose, insulin, C-peptide and insulin resistance. In conclusion, a shift from overweight/obesity to healthy weight can be accomplished by high adherence to personalized diet modification, not by EI reduction.
Adipose Tissue ; Adult ; Body Weight ; C-Peptide ; Cholesterol ; Compliance ; Diet ; Education ; Energy Intake ; Food Habits ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Lipoproteins ; Male ; Nutritionists ; Obesity ; Overweight ; Recommended Dietary Allowances ; Waist Circumference ; Weight Loss

PURPOSE: The Dietary Reference Intakes for Koreans (KDRIs) suggest that the goal for the intake of sodium should be less than 2,000 mg, which is thought to be infeasible to achieve when eating the typical Korean diet. This study aimed to obtain the new intake goals for sodium with improved feasibility to achieve, and also to design optimized food intake patterns for Korean adults by performing linear programming. METHODS: The data from a one day 24-hour dietary recall of the 2010 ~ 2014 Korea National Health and Nutrition Survey were used to quantify food items that Korean adults usually consumed. These food items were categorized into seven groups and 24 subgroups. The mean intakes and intake distributions of the food groups and the food subgroups were calculated for eight age (19 ~ 29, 30 ~ 49, 50 ~ 64, and over 65 years old) and gender (male and female) groups. A linear programming model was constructed to minimize the difference between the optimized intakes and the mean intakes of the food subgroups while meeting KDRIs for energy and 13 nutrients, and not exceeding the typical quantities of each of the food subgroups consumed by the respective age and gender groups. As an initial solution of the linear programming, the optimized intake of seasonings, including salt, was calculated as 0 g for all the age and gender groups when the sodium constraint was inserted not to exceed 2,000 mg. Therefore, the sodium constraint was progressively increased by 100 mg until the optimized intake of seasoning was obtained as the values closest to the 25(th) percentile of the intake distribution of seasonings for the respective age and gender groups. RESULTS: The optimized food intake patterns were mathematically obtained by performing linear programming when the sodium constraint values were 3,600 mg, 4,500 mg, 4,200 mg, 3,400 mg, 2,800 mg, 3,100 mg, 3,100 mg, and 2,500 mg for the eight age and gender groups. CONCLUSION: The optimized food intake patterns for Korean adults were designed by performing linear programming after increasing the sodium constraint values from 2,000 mg to 2500 ~ 4,500 mg according to the age and gender groups. The resulting patterns suggest that current diets should be modified to increase the intake of vegetables for all the groups, milk/dairy products for the female groups, and fruits for the female groups except for the females aged 50 ~ 64 years.
Adult ; Diet ; Eating ; Female ; Fruit ; Humans ; Korea ; Nutrition Surveys ; Nutritional Requirements ; Programming, Linear ; Recommended Dietary Allowances ; Seasons ; Sodium ; Vegetables

PURPOSE: The consumption of processed foods has recently been increasing due to changes in the living environment. The purpose of this study was to identify the contribution of processed food to the nutrient intake of adult Koreans. METHODS: A total of 15,760 adult people in the 6(th) National Health and Nutrition Examination Survey (2013 ~ 2015) were included in this study. According to the Korea Food and Drug Administration's classification criteria for processed foods, the 24 hour dietary recall data of the subjects were classified as processed food or natural food. The processed food intake, nutrient intake and major processed food sources by food groups were analyzed. RESULTS: Men consumed more processed foods than did the women. Consumption of processed foods decreased with age, but it increased with the education level and the income level. The total daily processed food intake accounted for 68.1% of the total food intake. The food groups with high processed food intake were beverage, vegetables, cereals and grain products, fruits, and milk and dairy products in this order. The top food source of each food groups were beer, kimchi, bread, processed apple products, and milk. After adjusting for age, gender, and energy intake, all the nutrient intakes and percentage of dietary reference intakes for Koreans, except carbohydrates, were significantly higher in processed foods than in natural foods. The sodium intake from the processed food was 96.3% of total daily sodium intake. The intakes of nutrients from processed foods, excluding vitamins C, dietary fiber, iron, and vitamin A, were higher in men than in women. The intake of sodium from processed foods was highest for people of 30 ~ 49 years of age, and the intake of sodium from processed foods decreased for people over 50. CONCLUSION: Korean adults consumed more processed food than the natural food, consuming more calories and most of the nutrients from the processed food overall total daily intakes. The intake of processed foods is expected to further increase in the future, and nutritional education and research on the ingestion and selection of healthy processed foods are necessary.
Adult ; Beer ; Beverages ; Bread ; Carbohydrates ; Classification ; Dairy Products ; Dietary Fiber ; Eating ; Edible Grain ; Education ; Energy Intake ; Female ; Fruit ; Humans ; Iron ; Korea ; Male ; Milk ; Nutrition Surveys ; Recommended Dietary Allowances ; Sodium ; Vegetables ; Vitamin A ; Vitamins